Governor’s budget would eliminate key safety net

Gov. Jerry Brown proposes to eliminate the MediCal Adult Day Health Care program. The order to shut down 300 small businesses providing high-level daily medical care for seniors could come in just 60 days if the Legislature approves his budget. This shortsighted and ill-considered cut mirrors the one proposed the previous two years by former Gov. Arnold Schwarzenegger that specifically targeted the health and well-being of our state’s most vulnerable elderly at a time when aging baby boomers will need access to this inexpensive alternative to high-cost, institutionalized skilled nursing home care.

In May 2010, the San Ysidro Health Center opened its new Adult Day Health Center in San Ysidro to provide comprehensive health and nursing services to low-income, frail elderly and disabled adults who require support in managing their chronic health and/or cognitive conditions. The new center, which currently serves 73 individuals and is licensed for 200, has received extremely positive response from the community and has allowed us to expand efforts to support participants and their families in need of help.

Adult day health centers currently serve about 45,000 Californians with disabilities. In San Diego, these centers care for thousands of frail elders and disabled adults. In southern San Diego County, adult day care centers provide services to nearly 1,000 individuals and the need is outpacing the available services. San Diego County’s Aging and Independence Services Agency reported that in 2007 the south county had 10,833 seniors eligible for in-home services, many of whom could benefit from having higher-level adult day health care services to meet their medical needs. In a 2010 demographic report, the agency projected that in coming years the total population of people over age 60 living in San Diego County will exceed half a million. The oldest age cohorts, growing at the fastest rate, have the highest likelihood of functional disabilities and chronic conditions, and will represent a significant challenge to the county in terms of service demands.

At San Ysidro Health Center, we care for nearly 5,254 patients over 65, with an additional 11,562 patients between 50 and 64. This patient population is at higher risk for chronic illnesses such as arthritis, cancer, diabetes, heart disease and hypertension, with the prevalence of multiple chronic conditions increasing with age. As individuals age, they become more susceptible to multiple chronic conditions that make it difficult for them to perform activities of daily living such as bathing, dressing, eating and transporting themselves.

The governor’s budgetary assumption that the elimination of ADHC services will translate into significant savings to the MediCal program is terribly flawed and misguided. In reality, ADHC services save the state from having to pay huge medical expenses associated with high-cost hospital stays, emergency room visits and admissions to skilled nursing facilities for acute medical conditions or injuries. This is confirmed by a recent study that estimated the state would lose $51 million in 2010-11 over and above the estimated savings that would come from eliminating the ADHC program, excluding the loss of federal matching funds.

Cutting adult day health services will further harm the state’s economy, with the loss of 7,000 jobs, $64 million in federal matching funds and millions more in tax revenue. It also will place 37,000 elderly and disabled MediCal beneficiaries at risk and force family members to quit their jobs to care for their elderly relatives. In addition, the governor’s proposal simply shifts costs to the Department of Developmental Services as persons with developmental disabilities are displaced from their ADHC program to costly alternatives. The state’s Lanterman Act requires that needed services be provided to these beneficiaries.

Frail elders and disabled adults – our parents, brothers, sisters, friends – are not statistics. They deserve programs and services that preserve their quality of life and peace of mind for those of us who care for them.

To allow the elimination of Adult Day Health Care services to move forward would be a grave, expensive and tragic mistake. We encourage everyone in the San Diego community to call elected state officials and join together to assure that we continue to support our frail seniors. It is the moral, ethical and responsible thing to do.